Cytoxan (Cyclophosphamide) for Lupus

Overview
Cytoxan, also known by its drug name, Cyclophosphamide, is a prescription medication originally approved by the Food and Drug Administration (FDA) for treating cancer in 1959. Cytoxan is most doctors’ treatment of choice for people with severe lupus, especially when it affects major organs such as the kidneys or lungs. Cytoxan is not appropriate for pregnant women or women who plan to become pregnant within a year of using Cytoxan. Cytoxan is not recommended for people who have urinary outflow obstruction. Cytoxan may not be appropriate for those who have blood disorders, liver problems, or infections. Cytoxan should be used with care in elderly people and those with increased risk for heart problems. Cytoxan is an immunosuppressant, or in other words, a drug that suppresses the immune system. Cytoxan is believed to work by preventing the production of deoxyribonucleic acid (DNA) in certain cells, including some cells in the immune system. Blocking DNA production causes those cells to die, thereby suppressing the immune system and weakening autoimmune attacks.

How do I take it?
For people with lupus nephritis (kidney disease), Cytoxan is most often administered as an intravenous infusion once a month for six months, then every three months for two years. The process of infusion usually takes one hour to administer the Cytoxan and about four hours to drink water before and after the treatment. Keeping well-hydrated is very important to help prevent serious side effects of Cytoxan. Continue drinking plenty of water when you return home after Cytoxan infusion. It is important for both men and women to use effective birth control while taking Cytoxan and for at least a year after they stop taking the drug. Always follow your doctor’s instructions exactly when taking Cytoxan.

Results
In 2006, a 10-year follow-up study found that the survival rate in China of people with lupus nephritis who were treated with Cyclophosphamide (Cytoxan) was 83 percent. Studies in Europe in 2002 and 2004 found that people with lupus nephritis who were treated with Cyclophosphamide followed by Azathioprine had a survival rate of 92 percent at 10 years.

Side effects
Serious side effects of Cytoxan include the risk of permanent infertility in both men and women and increased risk for some types of cancer, even years after treatment has stopped. Rarely, Cytoxan may cause serious heart problems. Seek medical help immediately if you experience trouble breathing, irregular heartbeat, or pain in your chest, jaw, left arm or abdomen while taking Cytoxan. Inform your doctor right away if you notice changes to your menstrual cycle, abdominal pain, black or bloody stools, sudden weight changes, or significant decrease in urine output. The most commonly reported side effects of Cytoxan are nausea, vomiting, minor temporary hair loss, darkening of the skin and nails, loss of appetite, fatigue, and anemia. Taking Cytoxan lowers your resistance to infection. Wash your hands frequently and avoid exposure to people who are ill or have recently been ill with a cold or flu. Consult your doctor before receiving vaccinations while taking Cytoxan. Inform your doctor if you develop signs of infection such as fever, chills or sore throat. Many drugs can cause allergic reactions which, in the most serious cases, can result in death. Seek immediate medical help if you experience signs of a severe allergic reaction such as difficulty breathing or swelling in the face, throat, eyes, lips or tongue.